A likely mechanism of chromosomal rearrangement formation involves joining the ends from two different chromosomal doublestrand breaks (DSBs). These events could potentially be mediated by either of two end-joining (EJ) repair pathways [canonical nonhomologous end joining (C-NHEJ) or alternative end joining (ALT-EJ)], which cause distinct rearrangement junction patterns. The relative role of these EJ pathways during rearrangement formation has remained controversial. Along these lines, we have tested whether the DNA damage response mediated by the Ataxia Telangiectasia Mutated (ATM) kinase may affect the relative influence of C-NHEJ vs. ALT-EJ on rearrangement formation. We developed a reporter in mouse cells for a 0.4-Mbp deletion rearrangement that is formed by EJ between two DSBs induced by the Cas9 endonuclease. We found that disruption of the ATM kinase causes an increase in the frequency of the rearrangement as well as a shift toward rearrangement junctions that show hallmarks of C-NHEJ. Furthermore, ATM suppresses rearrangement formation in an experimental condition, in which C-NHEJ is the predominant EJ repair event (i.e., expression of the 3′ exonuclease Trex2). Finally, several C-NHEJ factors are required for the increase in rearrangement frequency caused by inhibition of the ATM kinase. We also examined ATM effectors and found that H2AX shows a similar influence as ATM, whereas the influence of ATM on this rearrangement seems independent of 53BP1. We suggest that the contribution of the C-NHEJ pathway to the formation of a 0.4-Mbp deletion rearrangement is enhanced in ATM-deficient cells.hromosomal deletion rearrangements have been identified in several cancer genome studies. For example, an analysis of cancer cell lines found somatic deletions with an average size of 0.5 Mbp, some of which caused loss of tumor suppressor genes, including PTEN and RB (1). A likely mechanism for such rearrangements involves aberrant end-joining (EJ) repair that ligates distal ends of two different double-strand breaks (DSBs) on the same chromosome (i.e., distal EJ). Significant insight into deletion rearrangements has been derived from examining V(D)J recombination, which involves EJ repair of programmed DSBs that requires the KU70/KU80 heterodimer that binds DSB ends, DNA ligase 4 (LIG4), and the LIG4 cofactor XRCC4; they are collectively referred to as canonical (classical) nonhomologous end joining (C-NHEJ) (2). Another C-NHEJ factor is XLF, which forms nucleoprotein filaments with XRCC4 to promote LIG4 activity as well as DSB end bridging via an apparent sliding sleeve mechanism (3, 4).Although C-NHEJ is critical for V(D)J recombination of programmed DSBs, the relative importance of this pathway for other EJ-mediated rearrangements is controversial (5). Namely, another EJ repair pathway, alternative end joining (ALT-EJ), can also contribute to rearrangement formation. ALT-EJ is independent of C-NHEJ factors and mediated by LIG1 and/or LIG3 among other factors (5-7). Repair junctions mediated by these EJ pathways sh...